Maintained by Caitlin Brennan, NP, PhD. Last updated Wednesday, April 21st, 2020.
The rapid onset of the COVID-19 pandemic has placed an intense call to action on palliative and hospice clinicians to augment their ways of providing care to accommodate the increase in morbidity, mortality, and inpatient admissions associated with the virus. Below, we’ve compiled resources from hospice and palliative care leadership organizations and authorities, in the topics that are most pertinent right now.
Comprehensive Toolkits from Leading Palliative Care Orgs
Ariadne Labs – Serious Illness Care Program COVID-19 Response Toolkit
Center to Advance Palliative Care (CAPC) – COVID-19 Response Resources Toolkit
End of Life Care (ELNEC) from American Association of Colleges of Nursing – COVID-19 Nursing Support Toolkit
Advancing Expert Care – HPNA COVID-19 Resources
The Coalition to Transform Advanced Care (CTAC) – Resources to Support Serious Illness Population
On rapidly changing policy
The American Nurses Association Department of Policy & Government Affairs will be updating this page each Monday and Friday afternoon (and some days in between) with changes in the legislative, regulatory, and advocacy spaces surrounding COVID-19.
Communicating with patients
Ariadne Labs – COVID-19 Conversation Guide for Outpatient Care
NHPCO – Shared Decision-Making Tool for patients and providers, uses survival rates for COVID based on various pre-existing conditions.
VitalTalk – COVID-Ready Communication Skills. VitalTalk crowdsourced this primer to provide some practical advice on how to talk about some difficult topics related to COVID-19.
Although not developed specifically for COVID, these are helpful frameworks for facilitating goals of care / advance care planning discussions with patients and families:
Honoring Choices Massachusetts
Transitioning patients to telehealth
Center to Advance Palliative Care – Virtual Connection in an Age of Social Distancing. Dr. Michael Fratkin makes the case for telemedicine and provides tips for the best possible interaction during the COVID-19 pandemic.
Journal of Pain and Symptom Management – Telemedicine in the Time of Coronavirus. Detailed guidance for telemedicine set-up, patient and clinician considerations.
On Centers for Medicare and Medicaid Services 1135 Waivers
Updated April 2nd, 2020. Fact Sheet: CMS Issues Flexibilities for Hospice Providers. National Hospice and Palliative Care Organization (NHPCO).
Fact Sheet: 1135 Waiver FAQ. Updated March 25th, 2020. CMS
Emergency-Related Policies and Procedures That May Be Implemented Without 1135 Waivers
On PPE
CDC: Decontamination and Reuse of Filtering Facepiece Respirators. This document summarizes research about decontamination of FFRs before reuse.
CDC: Personal Protective Equipment Burn Rate Calculator. This is a spreadsheet-based model that provides information for healthcare facilities to plan and optimize the use of PPE.
Managing Care and Moral Dilemmas
From Cyft, Delivering Palliative Care in NYC during the COVID-19 Pandemic with Dr. Dana Lustbader
At the Top of the Covid-19 Curve, How Do Hospitals Decide Who Gets Treatment? from The New York Times
Compassionate Ventilator Withdrawal in COVID19 from College of Nursing, Wayne State University
Detroit hospital warns some coronavirus patients may not get ventilators from Bridge MI
Ethicists agree on who gets treated first when hospitals are overwhelmed by coronavirus from Quartz
Harvard Law Petrie-Flom Center: Disability and Rationing of Care amid COVID-19
Hastings Center: Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (COVID-19). Guidelines for Institutional Ethics Services Responding to COVID-19. Managing Uncertainty, Safeguarding Communities, Guiding Practice.
HPNA Podcast Corner: Moral Distress & Complicated Grief During COVID-19
NHPCO Worksheet: Ethical Framework for Decision Making in HPC During the COVID-19 Pandemic
Self-Care for Providers
“Providing Soul Care in the COVID-19 Era,” a blog written for CAPC by Grover W. L. Alford, Jr. and Rebecca Chester.
Harvard Business Review recently published an article, “Coping with Fatigue, Fear, and Panic During a Crisis.”
HPNA is offering a module on Integrating Self-Care Strategies. This module addresses the importance of integrating self-care strategies to manage moral distress and the impact of compassion fatigue. For members, this session is free until May 1st using code SELFCARE2020.
Social Work Palliative Care and Hospice Network (SWHPN) social workers will be hosting virtual chat rooms on Mondays thru Thursdays at 7:00 pm Eastern for any social worker as well as any hospice and palliative professional on a weekly basis. These will not have formal topics but will be focused on being safe places for clinicians and colleagues to share feelings and fears in an effort to find renewal, support, and social connection.
TEN PERCENT HAPPIER is offering a Coronavirus Sanity Guide, composed of meditations, podcasts, blog posts, and talks with free access to their app for Healthcare Workers at tenpercent.com/care.
Sharing data
The Palliative Care Quality Collaborative is collating experiences of palliative care clinicians in caring for COVID-19 positive, PUI (Person Under Investigation), and recovered patients. You can submit a voluntary short case report here.
More Detailed Support
Center to Advance Palliative Care hosts Virtual Office Hours.
Currently, all sessions are full, but will be added on an ongoing basis.
Sessions cover the following:
- What are some best practices with regard to anticipating needs and concerns when we do not have all of the answers at this time?
- How do I respond in situations when emotions are running high?
- What advice and guidance are there for responding to concerns related to having limited resources?
We will continue to update this page as more resources become available.